HIV and COVID-19: review of clinical course and outcomes

Figures & data

Table 1. Summary of 2020–2021 publications (through 15 July 2021) related to HIV and COVID-19.

First author	Population	Location	Publication date	Journal	Description or findings
Zhu, F.^26	1 PWH	China	11-Mar-20	J Med Virol	Described how PWH should be regarded as a vulnerable population in regard to COVID-19
Chen, J.^199	1 PWH	China	14-Apr-20	J Med Virol	Described a coinfected PWH with atypical CT imaging of the chest
Blanco, J.L.^33	5 PWH	Spain	15-Apr-20	Lancet HIV	Described clinical course of patients (<50 years old)
Wang, M.^82	1 PWH	China	23-Apr-20	Int J Infect Dis	COVID-19 and HIV (low CD4 count) led to a longer disease course
Aydin, O.A.^23	4 PWH	Turkey	29-Apr-20	J Med Virol	Comorbidities are an important factor in mortality for coinfected PWH
Ridgway, J.P.^41	8 PWH/1061 HIV negative controls	USA	7-May-20	AIDS Behav	PWH did not test positive for COVID-19 at a different rate than the general population
Hӓrter, G.^47	33 PWH	Germany	11-May-20	Infection	PWH did not have more severe morbidity or mortality than the general population
Gervasoni, C.^105	47 PWH	Italy	14-May-20	Clin Infect Dis	PWH coinfected with COVID-19 had favorable outcomes as compared to the general population
Patel, R.H.^106	1 PWH	USA	22-May-20	J Med Virol	Coinfected patient under treatment with ART had a less severe clinical presentation than the general hospitalized population
Iordanou, S.^81	1 PWH	Republic of Cyprus	25-May-20	J Med Virol	Coinfected (PWH/COVID-19) patient had a prolonged need for mechanical ventilation and increased risk for thrombotic complications
Childs, K.^49	18 PWH	United Kingdom	27-May-20	Clin Infect Dis	Black PWH were at higher risk of severe disease; ARTs did not appear to provide protection against COVID-19 severity
Vizcarra, P.^38	51 PWH and COVID-19 positive/1288 PWH	Spain	28-May-20	Lancet HIV	Clinical presentation in PWH was similar to the general population, however, lower CD4 counts affected disease severity; PWH had a higher prevalence of comorbidities
Okoh, A.K.^142	27 PWH	USA	28-May-20	J Acquir Immune Defic Syndr	Coinfected PWH presented similarly to the general population
Ridgway, J.P.^50	5 PWH	USA	29-May-20	AIDS Patient Care STDS	A similar COVID-19 clinical course was seen in PWH as in the general population
Shalev, N.^35	31 PWH	USA	30-May-20	Clin Infect Dis	HIV coinfection did not lead to increased rates of hospitalization; outcomes for PWH were similar to the general population
Suwanwongse, K.^27	9 PWH	USA	9-Jun-20	J Med Virol	PWH did not have more favorable COVID-19 outcomes especially when their CD4 counts were low
Coleman, H.^55	1 PWH	United Kingdom	10-Jun-20	AIDS	Pneumocystis jirovecii pneumonia and COVID-19 infection were observed in a PWH
Karmen-Tuohy, S.^80	21 PWH/42 HIV negative controls	USA	12-Jun-20	J Acquir Immune Defic Syndr	PWH had a higher admission rate for COVID-19 but did not show significant differences in ICU admissions, mechanical ventilator use, or mortality
Benkovic, S.^113	4 PWH	USA	16-Jun-20	J Med Virol	Clinical severity was not different in uncomplicated cases of COVID-19 and HIV coinfection as compared to the general population
Byrd, K.M.^115	27 PWH	USA	19-Jun-20	J Int AIDS Soc	Clinical course and severity appeared similar in PWH as the general public
Meyerowitz, E.A.^75	47 PWH	USA	25-Jun-20	AIDS	Coinfected PWH were on average 53.4 years old and a substantial proportion had comorbidities, were non-Hispanic Black, and lived or worked in a congregate setting
Del Amo, J.^202	236 PWH and COVID-19 positive/77,590 PWH receiving ART	Spain	26-Jun-20	Ann Intern Med	The risk for COVID-19 hospitalization was 20.3 among patients receiving TAF/FTC, 10.5 among those receiving TDF/FTC, 23.4 among those receiving ABC/3TC, and 20.0 for those receiving other regimens
Sigel, K.^74	88 PWH/405 HIV negative controls	USA	28-Jun-20	Clin Infect Dis	There was no difference in COVID-19 severity on admission by HIV status and PWH did not have more severe COVID-19 outcomes than the general population
Toombs, J.M.^129	3 PWH	United Kingdom	29-Jun-20	J Med Virol	PWH may be protected from severe COVID-19 if they are on ART
Ho, H.^84	72 PWH	USA	30-Jun-20	J Infect Dis	PWH were at higher risk for severe COVID-19 outcomes, especially those with increased markers of inflammation and immune dysfunction
Guo, W.^76	14 PWH	China	1-Jul-20	J Int AIDS Soc	HIV and COVID-19 coinfection led to a higher mortality rate and higher proportion of severe cases than the general population
Park, L.S.^44	30,891 PWH/76,745 HIV negative controls	USA	6-Jul-20	AIDS 2020 Conference	PWH had higher COVID-19 testing rates but no evidence to support increased positivity or more severe outcomes
Ruan, L.^102	4 PWH	China	6-Jul-20	J Med Virol	PWH in the stage of AIDS had a more complicated clinical course than those not in AIDS
Gudipati, S.^112	14 PWH	USA	15-Jul-20	J Acquir Immune Defic Syndr	PWH were not at a higher risk for severe COVID-19 outcomes
Mahmood, K.^196	1 PWH	USA	15-Jul-20	JACC Case Rep	Coinfected PWH on a LVAD
Cooper, T.J.^140	70 PWH	United Kingdom	15-Jul-20	HIV Med	PWH with well-controlled disease are not at risk of poorer COVID-19 outcomes than the general population
Adachi, E.^141	2 PWH	Japan	15-Jul-20	AIDS	Transgender PWH have similar clinical course of COVID-19 as compared to the general population
Charre, C.^39	77 PWH/27 PrEP users/19009 other patients	France	17-Jul-20	AIDS	The positivity rate appeared similar in HIV-infected patients, in PrEP users, and in other patients
Maggiolo, F.^61	55 PWH and COVID-19 postive/69 PWH	Italy	24-Jul-20	J Med Virol	HIV coinfection did not protect from COVID-19 coinfection or from severe disease
Su, J.^52	1 PWH	China	1-Aug-20	AIDS	Described COVID-19 in a patient with AIDS; speculated that protease inhibitors might have a protective effect for COVID-19
Stoeckle, K.^116	30 PWH/90 HIV-negative controls	USA	1-Aug-20	Open Forum Infect Dis	A similar COVID-19 clinical course was seen in PWH as in negative controls
Sun, L.J.^111	1 PWH	Singapore	1-Aug-20	J Acquir Immune Defic Syndr	He recovered from a mild and uncomplicated clinical course of COVID-19 without treatment
Calza, L.^48	26 PWH	Italy	3-Aug-20	Infection	PWH had a similar COVID-19 clinical presentation to the general population
Bhaskaran, K.^19	27480 PWH/17.3 million adults	United Kingdom	7-Aug-20	Lancet	PWH had nearly three-fold higher risk of COVID-19 death than those without HIV after adjusting for age and sex
Tian, C.^108	1 PWH	China	10-Aug-20	Ann Palliat Med	Described favorable outcome in coinfected PWH
Guo, W.^138	11 PWH	China	10-Aug-20	Res Sq	PWH have comparable COVID-19 morbidity rates as the general population,
Marbaniang, I.^158	167 PWH	India	13-Aug-20	Res Sq	¼ of PWH had anxiety during the COVID-19 pandemic
Huang, J.^34	35 PWH	China	17-Aug-20	Clin Infect Dis	PWH had similar severity and fatality from COVID-19 as the general population
Parker, A.^136	24 PWH/92 HIV negative controls	South Africa	21-Aug-20	S Afr Med J	Coinfected PWH had similar presentations and outcomes as those without HIV
Boulle, A.^91	553,749 PWH	South Africa	29-Aug-20	Clin Infect Dis	HIV was independently associated with increased COVID-19 mortality
Larzábal, F.J.^7	1 PWH	Argentina	31-Aug-20	Medicina	Described a PWH hospitalized with Pneumocysti jiroveccii and COVID-19 coinfection
Molina-Iturritza, E.^139	8 PWH	Spain	1-Sep-20	AIDS	The rate of COVID-19 in PWH is similar to the rate in the general population
Sasset, L.^70	2 PWH	Italy	1-Sep-20	AIDS	PWH had similar demographic and clinical characteristics to the general population
Hu, Y.^197	12 PWH	China	1-Sep-20	J Acquir Immune Defic Syndr	The value of ART for mitigation of COVID-19 infection is discussed
Shekhar, R.^110	5 PWH	USA	1-Sep-20	J Acquir Immune Defic Syndr	PWH may have a milder course of COVID-19 than the general population
Madge, S.^117	18 PWH	United Kingdom	2-Sep-20	Sex Transm Infect	PWH did not have prolonged hospital courses or worse outcomes compared to the general population
Etienne, N.^64	54 PWH and COVID-19 positive/4000 PWH	France	3-Sep-20	AIDS	PWH had worse COVID-19 outcomes when they were older age, male, had comorbidities, higher BMI, sub-Saharan Africa origins, had lower CD4 counts
Inciarte, A.^37	53 PWH and COVID-19 positive/5683 PWH	Spain	3-Sep-20	AIDS	Incidence rate of COVID-19 was lower in PWH compared to general population; clinical course of COVID-19 was not dependent on any HIV- or ART-related factor
Winston, A.^77	699 PWH/304 HIV negative controls	United Kingdom and Ireland	3-Sep-20	AIDS	PWH tended to have more comorbidities which was associated with poorer COVID-19 outcomes
d’Ettore, G.^31	1 PWH	Italy	4-Sep-20	Medicine	Coinfection of HIV and COVID-19 showed increased levels of IFNα/β and T-cell activation as compared to healthy individuals with COVID-19
Bertolini, M.^54	1 PWH	Argentina	9-Sep-20	Int J STD AIDS	Described a male patient with AIDS-related disseminated histoplasmosis associated with COVID-19
Dandachi, D.^20	286 PWH	USA	9-Sep-20	Clin Infect Dis	PWH were at higher risk for severe COVID-19 outcomes, especially those with comorbidities and lower CD cell counts
Akyala, A.I.^198	4 PWH	Nigeria	10-Sep-20	Pan Afr Med J	PWH experienced a mild COVID-19 clinical course
Nagarakanti, S.R.^114	23 PWH/23 HIV negative controls	USA	19-Sep-20	J Med Virol	Among, PWH, there was not higher mortality, ICU admissions, or mechanical ventilation in PWH than in the general population
Chiappe Gonzalez, A.J.^83	1 PWH	Peru	21-Sep-20	Int J STD AIDS	HIV/COVID-19 coinfection led to a fatal outcome
Mondi, A.^120	5 PWH	Italy	25-Sep-20	J Med Virol	PWH did not have more severe COVID-19 outcomes than the general population
Isernia, V.^78	30 PWH	France	26-Sep-20	Int J Infect Dis	HIV was not a risk factor for COVID-19
Sun, S.^150	703 PWH	China	Oct-20	AIDS Behav	PWH reported high rates of anxiety, depression, and insomnia
Collins, L.F.^46	20 PWH	USA	1-Oct-20	AIDS	PWH with more than 5 comorbidities, who are non-Hispanic Black, are male had more severe COVID-19 outcomes
Di Biagio, A.^206	4 PWH	Italy	1-Oct-20	AIDS	Protease inhibitor-based regimens were not protective against contracting COVID-19 in PWH
Yamamoto, S.^200	5 PWH	Japan	2-Oct-20	J Microbiol Immunol Infect	PWH coinfected with COVID-19 have a similar clinical course as patients without HIV
Kim, J.Y.^118	1 PWH	Korea	12-Oct-20	Korean Med Sci	PWH had a favorable clinical outcome with COVID-19
Gamboa, E.^123	1 PWH	USA	17-Oct-20	Cureus	Noted that CD4+ lymphocytes declined over the course of COVID-19 hospitalization in a PWH
Zhang, J.C.^32	2 PWH	China	19-Oct-20	BMC Infect Dis	Described the importance of accurate diagnosis for PWH with COVID-19 coinfection
Geretti, A.M.^85	115 PWH/47,424 HIV negative controls	United Kingdom	23-Oct-20	Clinical Infectious Diseases	Following additional adjustment for disease severity at presentation, mortality was higher in PWH
Yang, R.^97	3 PWH/53 HIV negative controls	China	27-Oct-20	Expert Review of Respiratory Medicine	Low CD4 count was a risk factor for severe COVID-19 outcomes
Cabello, A.^137	63 PWH	Spain	27-Oct-20	Int J Infect Dis	Coinfected PWH do not have different outcomes based on severity of HIV or type of ARV treatment
Di Biagio, A.^96	69 PWH	Italy	1-Nov-20	AIDS	Lower CD4 counts were associated with higher rates of COVID-19 hospital admission and more severe outcomes
Hadi, Y.B.^28	404 PWH/49,763 HIV negative controls	USA	1-Nov-20	AIDS	Propensity-matched analysis showed no difference in outcomes for PWH compared to the non-HIV controls; higher mortality was related to comorbidities
Siewe Fodjo, J.N.^157	317 PWH	Belgium, Brazil	1-Nov-20	J Acquir Immun Defic Syndr	23.3% of PWH screened positive for depression and 22.7% screened positive for anxiety during the COVID-19 pandemic
Morani, Z.^69	43 PWH	Belize, USA	2-Nov-20	SN Compr Clin Med	Comorbidities and advanced age make PWH more prone to worse COVID-19 outcomes
Tesoriero, J.M.^90	2988 PWH	USA	6-Nov-20	MedRxiv	PWH experienced poorer COVID-19 related outcomes than those without HIV
Jones, D.L.^163	1554 PWH	Argentina, USA	18-Nov-20	Res Sq	PWH who had higher levels of social support reported less depression during the COVID-19 pandemic
D'Souza, G.^53	2078 PWH/1333 HIV negative controls	USA	19-Nov-20	HIV Res Clin Pract	PWH had similar prevalence and type of COVID-19 symptoms as the general population
Sachdev, D.^42	193 PWH and COVID-19 positive/4252 PWH	USA	20-Nov-20	J Acquir Immune Defic Syndr	PWH were more susceptible to COVID-19 than those without HIV
Turken, M.^98	4 PWH	Turkey	30-Nov-20	Curr HIV Res	Two patients with normal CD4+ count had mild coinfections, a patient with low CD4+ count died
Braunstein, S.L.^103	2410 PWH	USA	30-Nov-20	Clin Infect Dis	More PWH had adverse COVID-19 outcomes than the general population, perhaps due to comorbidities and other social determinants of health
Swaminathan, N.^145	6 PWH	USA	1-Dec-20	J Med Virol	PWH had similar mortality when compared to other studies
Hardy, Y.O.^127	3 PWH	Ghana	Dec-20	Ghana Med J	PWH with advanced immunosuppression may not have an unfavorable COVID-19 disease outcome
Kowalska, J.D.^122	34 PWH	Central and Eastern Europe	13-Dec-20	Int J Infect Dis	HIV serostatus was not associated with more severe disease
Kuman Tuncel, O.^159	307 PWH	Turkey	17-Dec-20	Turk J Med Sci	A significant proportion of PWH had anxiety during the COVID-19 pandemic
Hoffmann, C.^209	175 PWH	Germany, Spain, Italy	27-Dec-20	HIV Med	Virological suppression was possibly related to severe COVID-19 outcomes; no evidence of protective effect by ARTs
Noe, S.^135	500 PWH	Germany	2-Jan-21	Infection	There were no marked differences for PWH with and without SARS-CoV-2 co-infection
Cooley, S.A.^156	54 PWH/133 HIV negative controls	USA	6-Jan-21	J Neurovirol	PWH had increased symptoms of anxiety and depression during the COVID-19 pandemic
Laracy, J.^132	68 PWH/272 HIV negative controls	USA	28-Jan-21	Open Forum Infect Dis	PWH did not did not differ from HIV-uninfected controls by rate of mechanical ventilation or death
Tesoriero, J.M.^89	2988 PWH/2409 HIV negative controls	USA	1-Feb-21	JAMA Netw Open	PWH experienced poorer COVID-19 outcomes than the general population
Patel, V.V.^134	100 PWH/4513 HIV negative controls	USA	1-Feb-21	Acquir Immune Defic Syndr	PWH had increased risk of intubation but similarly frequent rates of AKI and in-hospital death as those without HIV
Ceballos, M.E.^133	36 PWH	Chile	3-Feb-21	Int J STD AIDS	No differences were found between PWH and the general population in the need for mechanical ventilation and death
Nasreddine, R.^65	101 PWH	Belgium	9-Feb-21	J Med Virol	HIV patients with COVID-19 experienced a high degree of hospitalization
Delle Donne, V.^162	98 PWH	Italy	1-Mar-21	Infez Med	Almost half of PWH experienced significant distress due to the COVID-19 pandemic
Eybpoosh, S.^124	90 PWH	Iran	10-Mar-21	Med J Islam Repub Iran	HIV infection was not a risk factor for increased COVID-19 severity and death
Sorbera, M.^183	211 PWH	USA	16-Mar-21	J Am Coll Clin Pharm	Telehealth for pharmacy services did not jeopardize patient outcomes
Weerasuria, M.^149	153 PWH	Australia	17-Mar-21	AIDS Res Hum Retroviruses	Telehealth was widely used; many PWH experienced negative mental health in the COVID-19 pandemic
Farinacci, D.^59	1 PWH	Italy	31-Mar-21	AIDS Res Hum Retroviruses	PWH coinfected with Pneumocystis jirovecii
Durstenfeld, M.S.^128	220 PWH	USA	7-Apr-21	MedRxiv	HIV was not associated with adverse outcomes of COVID-19
Mohindra, R.^130	1 PWH/1 HIV negative control	India	7-Apr-21	Virus disease	PWH had a similar clinical course to HIV negative persons
Liu, W.^146	1 PWH	Taiwan	21-Apr-21	J Formos Med Assoc	The clinical presentation of coinfected PWH were similar to other COVID-19 patients without HIV infection
Diaz, M.M.^153	156 PWH	Peru	26-Apr-21	MedRxiv	PWH reported increased anxiety and stress during the COVID-19 pandemic
Mang, S.^60	1 PWH	Germany	26-Apr-21	Clin Infect Dis	PWH coinfected with COVID-19 and Pneumocystis jirovecii
Siewe Fodjo, J.N.^154	247 PWH	Brazil	27-Apr-21	Int J Environ Res Public Health	27.1% of PWH screened positive for anxiety, 27.9% screened positive for depression during the COVID-19 pandemic
Spinelli, M.A.^87	955 PWH/1062 HIV negative controls	USA	29-Apr-21	Lancet HIV	PWH had more cases of severe COVID-19
Liang, M.^104	7718 PWH/196,043 HIV negative controls	China	3-May-21	Infect Dis Ther	Coinfected PWH were not associated with higher COVID-19 mortality
Merchant, E.A.^58	1 PWH	USA	7-May-21	ID Cases	Coinfection PWH had PJP
Charifi, Y.^57	1 PWH	Morocco	15-May-21	Clin Case Rep	Coinfected PWH had pneumocystis with typical lesions
Massarvva, T.^126	730 PWH	Cyprus	17-May-21	Epidemiol Health	Coinfected PWH had comparable clinical outcomes with the general population
Kumar, S.^151	167 PWH	India	19-May-21	New Microbes New Infect	Many PWH experience fear, anxiety and depression in the COVID-19 pandemic
Venturas, J.^125	108 PWH/276 HIV negative controls	South Africa	26-May-21	J Infect	HIV is not a risk factor for severe COVID-19 disease or mortality
Ader, F.^210	583 patients	France	26-May-21	Clin Microbiol Infect	COVID-19 clearance and clinical status were not improved but lopinavir/ritonavir
Pujari, S.^67	86 PWH	India	31-May-21	AIDS Res Hum Retroviruses	Coinfected PWH had similar clinical outcomes as the general population; comorbidities are associated with more severe outcomes
Pujari, S.^95	94 PWH	India	2-Jun-21	Immun Inflamm Dis	Long-COVID is common among PWH with moderate-severe acute COVID-19
Rocha, S.Q.^63	255 PWH	Brazil	4-Jun-21	AIDS Care	Skin color/race, and schooling remained significantly associated with higher COVID-19 mortality in PWH
Chanda, D.^101	122 PWH	Zambia	4-Jun-21	MMWR	Severe HIV is associated with increased risk of COVID-19 death
Di Castelnuovo, A.^213	3,451 patients	Italy	9-Jun-21	Front med	DRV/c was associated with increased mortality
Wu, M.^56	68 PWH/980 HIV negative controls	China	9-Jun-21	Res Sq	Older age was considered a driving force for coinfection in PWH
Wion, R.K.^152	154 PWH	USA	15-Jun-21	AIDS Behav	PWH experienced an increase in social isolation, depression, and stress
Flannery, S.^99	99 PWH	USA	22-Jun-21	Int J STD AIDS	Hospitalized coinfected PWH did not have worse outcomes than the general population; PWH who had CD4% <14 or not on treatment for HIV had higher mortality rates
Berenguer, J.^203	91 PWH	Spain	26-Jun-21	Clin Microbiol Infect	TDF/FTC may prevent SARS-CoV-2 infection among PWH
Dong, Y.^93	41,113 PWH/ 18,081,257 HIV negative controls	China	2-Jul-21	Medicine (Baltimore)	PWH had a higher risk of mortality from COVID-19 than those without HIV infection
Bertagnolio, S.^92	15,522 PWH/168,649 negative controls	24 countries	15-Jul-21	WHO	PWH were at increased risk for severe or critical COVID-19

Abbreviations: PWH, person(s) living with HIV; ART, antiretroviral therapy; USA: United States of America.

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